Ambulances to have wasted journeys cut

Published on Wednesday, 16 May 2012 15:34
Posted by Scott Buckler

At least 150 lives could be saved under changes to the way 999 calls are received which will prioritise call outs to the most critically ill patients. The changes will mean that ambulances are saved from making over half a million wasted journeys a year

From June 2012, ambulance staff will be given up to 60 seconds longer to get more information from Red 2 calls. This will not necessarily translate into a 60 second delay, in many cases it will mean that a more appropriate response vehicle gets to the patient more quickly. Under the new system the Government will expect Ambulance Trusts to get to more critically ill patients within the 8 minute national target.

Allowing staff to establish more information about the incident they are responding to will ensure that they are able to send the most appropriate response vehicle first time to patients, meaning that less ambulance journeys are wasted or cancelled and that there are more ambulances available for all the patients that need them. For the most serious calls, where every second counts, ambulances will continue to be dispatched immediately.

Two pilots trialling the changes in London and the West Midlands took over 22,000 calls and showed those in critical need were reached at least 40 seconds faster, and demonstrated at least a 24% reduction in cancellations. If replicated elsewhere, this would result in saving at least 650,000 wasted ambulances journeys across England.  While top priority calls were reached up to 40 seconds quicker, Red 2 calls were responded to between 27 seconds quicker and 9 seconds slower.  The nature of Red 2 incidents is such that a 9 second delay would not have a negative impact on the patient.

Ambulances must reach 75 per cent of all patients who need urgent medical assistance within 8 minutes. In order to meet this target, Ambulance Trusts frequently send more than one vehicle – such as an ambulance and a Rapid Responder – to each patient, known as ‘double dispatch’.  But on average, over 20 per cent of these vehicles are then cancelled on route before reaching the scene, wasting vital resources which could and should be used for other patients.  Because the new system will free up more vehicles, Ambulance Trusts will be expected to work towards responding to 80 per cent of the most urgent patients within 8 minutes.

These changes come in response to evidence presented by ambulance staff as well as reports by the National Audit Office and the Public Accounts Committee in 2011.
Matthew Cooke, National Clinical Director for Urgent and Emergency Care and a consultant in emergency medicine, said:
“We want to make sure that everyone who needs emergency medical assistance gets it.  These changes will make sure that the right support is sent to the right place and reaches patients fast.
“Fewer ambulances will need to be stood down when they are half way to a patient who doesn’t need them – meaning that they will be available for a patient who does, increasing the chances of survival for anyone who is not breathing or is suffering a cardiac arrest. People whose heart has stopped will get a faster response, meaning they can have life saving treatment like defibrillation on average 40 seconds quicker, increasing their chances of  survival by about 7 percent.
“But time is still an important factor, which is why we are measuring not only how fast ambulances reach patients, but also their clinical results, which are both what matters to patients and their families.”
Peter Bradley, Chief Executive of London Ambulance Service and National Ambulance Director, said:
At the moment, too many ambulances or rapid response vehicles are sent out when they are not needed. This means that paramedics are sent out on a double dispatch, only to be cancelled when they are too far away to reach another urgent call.
“Making this small change will mean more ambulances and rapid responders will be ready to go and help patients – rather than be stood down while on their way to somewhere they aren’t needed.”
Stuart Gardner, who is a paramedic at West Midlands Ambulance Service and Staffside Chair for Unison, Unite and GMB, added:
All three unions welcome the change to the clock start. We firmly believe that it will benefit patients by ensuring that those that are in the most need, get an ambulance even more quickly than they do now.  From a staff perspective, it will also mean a reduction in the number of times we are sent on an incident and then get stood down before we arrive. 
“Whilst we understand the reasons why it happens, it can be very frustrating ending up driving the same piece of road several times in only a few minutes.  These changes will ensure we spend more time treating patients which has to be a good thing.”
If those taking the call have not got all the information they need in 60 seconds, the clock will start counting down the 8 minute target anyway. People taking the calls will be getting simple and vital additional information like:
•       whether the patient is breathing and has a pulse;
•       more detail on what has happened to them and their symptoms;
As Ambulance Trusts have more capacity to reach all their patients quickly, they will also:

•       have to improve their performance in 2012/13 to show by April 2013 that they can reach 80 per cent of these most urgent patients within 8 minutes, and
•       be required to publish how long it takes them to reach 95 per cent of all their patients from June 2012 to encourage them to bring down the number of people who wait the longest, particularly in rural areas.

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